Individual provider Active NPI

Karina Andrea Jeifez-Zagagi, PH.D.

  • Clinical Neuropsychologist
  • Jacksonville, FL
National Provider Identifier
1639440415
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8339 Issued in FL
Practice address
1650 Prudential Dr
Suite 210
Jacksonville, FL 32207-8147
Phone
(904) 376-3800
Fax
(904) 396-8966
NPI assigned
Jan 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY8339 FL
Clinical Child & Adolescent Psychologist 103TC2200X PY8339 FL
Clinical Neuropsychologist 103G00000X PY8339 FL Primary

Addresses

Primary practice location

1650 Prudential Dr
Suite 210
Jacksonville, FL 32207-8147

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130318000099 FL Practitioner - Psychiatry 5496990608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC CurrentSince May 23, 2016 Accepting new patients

Locations

1650 Prudential Dr
Ste 210
Jacksonville, FL 32207

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

4160 University Blvd S
Jacksonville, FL 32216
Phone (904) 308-2058

3650 NW Devane St
Lake City, FL 32055
Phone (386) 755-1221

96098 Victorias Pl
Ste 201
Yulee, FL 32097

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1639440415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 PRUDENTIAL DR",
            "address_2": "SUITE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078147",
            "telephone_number": "904-376-3800",
            "fax_number": "904-396-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEIFEZ-ZAGAGI",
        "first_name": "KARINA",
        "middle_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8339",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY8339",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.